Timothy Olanrewaju, Maiduguri
Ali Bulama (not real name) managed a multi-million naira fish business in Baga, a fishing community on the shore of Lake Chad in Northeast Borno State.
As a fish merchant for about 15 years, he built a big house for his four wives, about 20 children and nearly a dozen dependents from his earnings, including other trades in a few shops in the town. His house was usually a beehive of activities especially during Ramadan or Muslim festivals; Eid Kabir or Fitri until the unexpected came.
He had just withdrawn a large sum of money to purchase cartoons of fishes for sale early in January 2015, when Boko Haram struck, Sunday Sun gathered.
“We were hearing heavy sound of firing. Nobody understood what was happening until people started running into different directions and many ended up in Boko Haram hands,” Mohammad Aji, a survivor of the attack who now lives in Maiduguri, Borno capital told Sunday Sun.
Bulama survived the attack as he escaped to Maiduguri, some 157 kilometres, leaving behind some of his family members trapped in the crossfire between the insurgents and military troops. A source who is conversant with the tragic story said the fish merchant’s house and businesses were destroyed. The boat of his once thriving business capsized and life became very miserable for the man. He had to depend on others for food, a condition, which Sunday Sun gathered trigged his depression.
The once vibrant fish merchant suddenly became reclusive, cut his interaction with others. It was a depression blow that gradually pushed the man into psychiatric condition, medical experts said. Bulama is not the only one affected by depression. The casualties are many.
Mariya Duniya, 80 and 32-year-old Zainab Audu have been receiving mental health support from a facility, Medicine Sans Frontiers (MSF) in Pulka, a hilly town Southeast of Maiduguri. Life became meaningless to Mama Mariya after the killing of four of her nine children in the violence, she once told the volunteer group, MSF also known as Doctors Without Borders.
Most residents of her community fled for safety after Boko Haram attacks, leaving behind only the elderly one. Lonely and already traumatized by the killing of her four children and left behind without food, depression crept in.
“None of my children will bury me when I die,” she said.
The Nigerian military arrived in their village on patrol and transported them to Pulka, but without her children.
For Zainab, she has seen four of her 10 children killed in the violence. She and her family fled to Pulka, but her husband was detained by the military on arrival in the town. Sadly, she was left on her own to care for her six children, one of whom was very sick. Zainab became overwhelmed with the challenges of her children loss, a husband held in military detention and survival.
Many more in depression
Nearly a quarter of the 12,000 IDPs in Pulka are receiving mental health treatment, MSF Field Communication Manager, Borno State, Yuna Cho said.
“Desperate living conditions and lack of protection in Pulka are exacerbating people’s acute mental health needs. One in 25 patients had a severe mental health disorder with psychiatric symptoms,” he said, calling for urgent “reinforcement of the humanitarian response.”
Scores of people that have experienced much of the killings, social and economic displacement particularly in Borno, now suffer from violence-induced stress and trauma, Chief Medical Officer, Federal Neuro-Psychiatric Hospital Maiduguri, Dr Ibrahim Wakawa disclosed in an interview with Sunday Sun.
He added that such condition often grow into depression.
He said depressed victims could also suffer post-trauma stress, which occurs after a sad experience. In this case, he said victims start manifesting signs of trauma after experiencing gruesome murder of family members, sudden change in economic status, among others.
The psychiatric hospital in Maiduguri was established over two decades ago to cater for mental health condition and research centre in the Northeast zone.
Little did the founders know a decade long insurgency was ahead that would require huge contribution of the institution.
The hospital said it has so far received 7,000 patients that have direct mental complication as a result of insurgency.
“So far, we have seen over 4,000 patients through WHO and 3,000 through IOM camps. So, in essence, we have seen over 7,000 people that have direct mental complication because of insurgency,” the CMO disclosed. He added that some people still come to the hospital on their own without link with the international organizations.
He said nearly all the patients were victims of post-trauma disorder; a mental condition, which he said was not common in the hospital in the past until insurgency broke out in the Northeast.
“They were not common in the hospital, but with insurgency, they became very prevalent and we have seen them more often than before,” he said. With gruesome murder of loved ones in their presence by Boko Haram, destruction of their homes, displacement and dislocation, depression could only be the end result.
Shadow of insanity
Experts described post-traumatic stress disorder in the Northeast as a situation in which victims think and relieve their tragic experiences in the recent past.
“The victims will find it difficult to live their life the way they used to do. When such situation predominates, it predisposes such persons to major mental issue,” Wakawa explained.
A person’s mental state could deteriorate when he or she loses touch with the reality perhaps due to frustration and/or depression, a WHO mental health expert, Dr Samuel Tarfa explained.
“A person leaves sanity to insanity when he or she loses contact with reality; that is perceptions in the absence of stimulus, illogical and irrational thinking, bizarre and disturbing behaviour, abnormal anxiety, panic, despair and negative self talk,” he stated.
According to him, common triggers of psychiatric cases result from external events or circumstances for example, frightening and overwhelming events or experience. Others include losses and disappointments, work related stresses, family friction, drugs, physical illness and high body temperature, loneliness, financial distress and incensed criticisms.
The psychiatric hospital in Maiduguri, the only federal institution offering mental service, said it gets support from WHO for the treatment of the patients.
It, however, wishes it gets more support from well-meaning Nigerians, especially in the Northeast to help bring many of the patients back to the realm of sanity.